Dr. Whitten just evaluated Ms. Sanchez and has written the following orders: Choose which order must be completed first.

Ceftriaxone 1 gm IVPB

Antipyretic given every 6 hours

Blood and sputum cultures

Monitor Blood Glucose before meals and at Bedtime

Monitor I and O

Answer and Explanation

The Correct Answer is C

Choice A reason: Ceftriaxone treats infection, but giving it before cultures risks sterilizing samples, skewing results. It’s critical therapy, yet obtaining accurate diagnostics first ensures targeted treatment, delaying antibiotics briefly.

Choice B reason: Antipyretics reduce fever, a symptom, not the cause. Cultures take priority to identify pathogens before comfort measures, as fever management doesn’t alter diagnostic or treatment urgency in this case.

Choice C reason: Blood and sputum cultures identify the causative organism in suspected infection (e.g., pneumonia). They must be obtained first, before antibiotics, to ensure accuracy, guiding effective therapy and avoiding false negatives.

Choice D reason: Monitoring glucose is routine, not urgent in acute infection unless diabetic crisis is suspected. Cultures precede this, as identifying the pathogen drives treatment, while glucose can wait without immediate risk.

Choice E reason: Monitoring intake and output tracks fluid status, useful but secondary in acute infection. Cultures are the priority to diagnose and treat effectively, as I&O doesn’t alter initial management decisions.

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Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Aspirin prevents thrombosis in coronary disease, not a primary heart failure treatment. It reduces ischemic risk but doesn’t address fluid overload or cardiac workload, lacking direct symptom relief in heart failure management.

Choice B reason: Lisinopril, an ACE inhibitor, reduces afterload and preload by vasodilation, easing heart strain. It manages heart failure symptoms like dyspnea by improving cardiac output, a cornerstone therapy for pump dysfunction.

Choice C reason: Insulin Glargine controls diabetes, not heart failure symptoms. It manages glucose, indirectly benefiting cardiovascular health, but doesn’t relieve congestion or improve hemodynamics, making it irrelevant to direct symptom management.

Choice D reason: Furosemide, a diuretic, reduces fluid overload in heart failure, alleviating dyspnea and edema. It lowers preload by increasing urine output, directly targeting congestion, a key symptom, in evidence-based practice.

Choice E reason: Metoprolol, a beta-blocker, slows heart rate, reducing myocardial demand in heart failure. It improves ejection fraction and symptoms like fatigue, a standard therapy for stabilizing cardiac function long-term.

A. Mild left ventricular hypertrophy on x-ray B. Total cholesterol of 210 mg/dL C. Hemoglobin A1C of 7.5% D. Sodium level of 138 E. Creatinine level of 1.6 F. Oxygen saturation of 95% on room air

Correct Answer is ["A","B","C","E"]

Explanation

Choice A reason: Mild left ventricular hypertrophy indicates cardiac strain from chronic hypertension, increasing risk for heart failure or infarction. It reflects structural change, elevating cardiovascular morbidity as pressure overload progresses, a known precursor to serious events.

Choice B reason: Total cholesterol of 210 mg/dL exceeds optimal (<200 mg/dL), promoting atherosclerosis. Lipid plaques narrow arteries, raising risks for coronary artery disease and stroke, a well-established cardiovascular risk factor needing intervention.

Choice C reason: Hemoglobin A1C of 7.5% shows poor glycemic control (>6.5% is diabetes), damaging vessels via glycation. This accelerates atherosclerosis and microvascular complications, significantly increasing cardiovascular event risk in uncontrolled diabetes.

Choice D reason: Sodium of 138 mEq/L is normal (135-145 mEq/L), not impacting cardiovascular risk directly. It influences fluid balance, but this value doesn’t suggest hypertension or heart strain, making it irrelevant here.

Choice E reason: Creatinine of 1.6 mg/dL (>1.2 mg/dL) signals renal impairment, often from hypertension or diabetes. Kidney dysfunction raises cardiovascular risk by disrupting fluid and pressure regulation, contributing to heart disease progression.

Choice F reason: Oxygen saturation of 95% on room air is normal (95-100%), indicating adequate lung function. It doesn’t suggest hypoxia or cardiovascular compromise, so it’s not a risk factor in this context.

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Dr. Whitten just evaluated Ms. Sanchez and has written the following orders: Choose which order must be completed first.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing the patient’s medication list. Which of the following medications are commonly prescribed to manage symptoms of heart failure? (Select all that apply)

Correct Answer is ["B","D","E"]

Explanation

The nurse is reviewing the patient’s history and recent lab results. Which of the following findings indicate an increased risk for cardiovascular complications? (Select all that apply)

Correct Answer is ["A","B","C","E"]

Explanation

A patient with chronic obstructive pulmonary disease (COPD) arrives in the emergency department reporting shortness of breath on minimal exertion. Which assessment finding by the nurse would be most important to report to the health care provider?

The nurse is reviewing the patient’s recent symptoms and lab results. Which of the following symptoms or findings suggest worsening heart failure? (Select all that apply)

A patient is hospitalized with active tuberculosis (TB). Which assessment finding indicates to the nurse that prescribed airborne precautions are likely to be discontinued?

A 65-year-old patient with a history of Peripheral Artery Disease (PAD) presents to the clinic with complaints of intermittent claudication in the right leg. Which of the following management strategies should the nurse prioritize to improve the patient’s condition?

The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is important to communicate to the health care provider?

An hour after a left thoracotomy, a patient reports incisional pain at a level 7 (based on 0 to 10 scale) and has decreased left-sided breath sounds. The pleural drainage system has 100 mL of bloody drainage. Which action would the nurse take?

Which nursing intervention is important when providing care for a patient in sickle cell crisis?

The nurse assesses vital signs for a patient admitted 2 days ago with gram-negative sepsis: temperature of 101.2°F, blood pressure of 90/56 mm Hg, pulse of 92 beats/min, and respirations of 34 breaths/min. Which action would the nurse take next?